British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC V5Z 4R4, Canada.
Harm Reduct J. 2014 Apr 27;11:13. doi: 10.1186/1477-7517-11-13.
In British Columbia (BC), understanding of high-risk drug use trends is largely based on survey and cohort study data from two major cities, which may not be representative of persons who use drugs in other regions. Harm reduction stakeholders, representing each of the five geographic health regions in BC, identified a need for data on drug use to inform local and regional harm reduction activities across the province. The aims of this project were to (1) develop a drug use survey that could be feasibly administered at harm reduction (HR) sites across all health regions and (2) assess the data for differences in reported drug use frequencies by region.
A pilot survey focusing on current drug use was developed with stakeholders and administered among clients at 28 HR supply distribution sites across the province by existing staff and peers. Data were collated and analysed using univariate and bivariate descriptive statistics to assess differences in reported drug use frequencies by geography. A post-survey evaluation was conducted to assess acceptability and feasibility of the survey process for participating sites.
Crack cocaine, heroin, and morphine were the most frequently reported drugs with notable regional differences. Polysubstance use was common among respondents (70%) with one region having 81% polysubstance use. Respondents surveyed in or near their region's major centre were more likely to report having used crack cocaine (p < 0.0001) and heroin (p < 0.0001) in the past week as compared to those residing >50 km from the major centre. Participants accessing services >50 km from the regional centre were more likely to have used morphine (p < 0.0001). There was no difference in powder cocaine use by client/site proximity to the regional centre. Participating sites found the survey process acceptable, feasible to administer annually, and useful for responding to client needs.
The survey was a feasible way for harm reduction sites across BC to obtain drug use data from clients who actively use drugs. Drug use frequencies differed substantially by region and community proximity to the regional centre, underlining the need for locally collected data to inform service planning.
在不列颠哥伦比亚省（BC），对高危药物使用趋势的了解主要基于来自两个主要城市的调查和队列研究数据，这些数据可能无法代表该省其他地区的药物使用者。减少伤害的利益相关者代表 BC 五个地理卫生区域中的每一个，他们认为需要有关药物使用的数据来为全省各地和地区的减少伤害活动提供信息。该项目的目的是：（1）制定一项可行的药物使用调查，以便在全省所有卫生区域的减少伤害场所进行；（2）评估报告的药物使用频率在不同地区之间的差异。
与利益相关者合作制定了一项重点关注当前药物使用情况的试点调查，并由省内 28 个减少伤害供应分配点的现有工作人员和同行对客户进行调查。使用单变量和双变量描述性统计方法收集和分析数据，以评估地理区域报告的药物使用频率差异。进行了一项调查后评估，以评估参与场所调查过程的可接受性和可行性。
可卡因、海洛因和吗啡是最常报告的药物，且存在显著的地区差异。受访者中普遍存在多种物质使用（70%），一个地区的多种物质使用比例为 81%。与居住在主要中心 50 公里以外的受访者相比，居住在其所在地区主要中心或附近的受访者更有可能在过去一周内报告使用可卡因（p < 0.0001）和海洛因（p < 0.0001）。与居住在主要中心 50 公里以外的地区中心的客户相比，使用吗啡的客户更有可能接受服务（p < 0.0001）。距离地区中心较近的客户与较远的客户在使用可卡因粉方面没有差异。参与调查的地点认为调查过程是可以接受的，每年都可以进行管理，并且对满足客户的需求很有用。
该调查为不列颠哥伦比亚省各地的减少伤害场所提供了一种从积极使用药物的客户那里获取药物使用数据的可行方法。不同地区和社区与地区中心的距离不同，药物使用频率也有很大差异，这突显了需要收集当地数据来为服务规划提供信息。
